2018 module exam Flashcards by Hessa Al Salem

Which of the following is inhibited by Sildenafil and can cause blindness?

A) Guanyl Cyclase
B) PDE
C) tranduction

B) PDE

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Which of the following neurodegenerative disorders is characterized by GAA repeats?

A) Friedrech ataxia
B) Parkinson
C) Alzheimer’s
D) Huntington disease

A) Friedrech ataxia

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What is the underlying abnormality in AD after mutation?

A) Accumulation of APP
B) Defective processing of APP
C) Incorrect folding of APP

B) Defective processing of APP

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66 yr female climbing stairs has fasciculations, muscle wasting, hyperreflexia, positive Hoffman sign & babinski sign, what’s the diagnosis?

A) ALS
B) MG
C) MA
D) DM ployneuropathy

A) ALS

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MOA istrafel?

treatment of “off” symptoms

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A patient with proximal muscle weakness and muscarinic symptoms is suspected to have Lambert-Eaton Myasthenic Syndrome, what is the target of the auto-Abs in this disease?

A) MuSK
B) AchR
C) VGCC
D) SNARE

C) VGCC

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parkinson symptomes treated with a drug and get better in one year

levodopa

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Which drug decreases the side effects of levodopa peripherally?

A) Domperidone
B) Carbidopa

A) Domperidone

But both can be counted correct, check with the dr

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Which one of the following tests is used in the diagnosis of narcolepsy with high specificity?

A) standard EEG
B) multiple sleep latency test
C) actigraphy
D) frittin level

B) multiple sleep latency test

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55-year-old man with acting out his vivid dreams and loss of smell. It occurs early in the morning. The patient is at risk of developing what disease?

A) Alzheimer disease
B) ischemic brain stroke
C) lewy body dementia
D) progressive supranuclear palsy

C) lewy body dementia

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23 Y/O male w/ severe headache, photophobia, and neck stiffness. He had non-blanching rash on his trunk. He recently recovered from chicken pox. On examination he was pyrexic at 39°C. What is the most likely causative agent?

A) N. Gonorrhea
B) N. Meningitidis
C) S. Pneumonia
D) L. Monocytogenes
E) Varicella zoster virus

E) Varicella zoster virus

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A 35 yr old man presented w/ double vision. On examination when looking to the Rt eye he couldn’t adduct his left eye & there was nystagmus in his right eye. Where is the localization of this lesion?

A) MLF
B) medial leminscus
C) superior colliculi
D) parapontinar reticular fromation

A) MLF

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Low glucose and high lymphocytes.

A) meningococcal meningitis
B)TB
C) viral encephalitis

(Question is incomplete  but if the glucose is normal it can’t be viral, and since
lymphocytes are high not the neutrophils, then it’s TB not bacterial)

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A patient presented with nuchal rigidity, headache, & fever. On lumbar puncture, CSF showed markedly increased lymphocytes presumptive of viral meningitis. What is the most common cause of this condition?

A) Adenoviruses
B) Enteroviruses
C) Human papilloma virus

B) Enteroviruses

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What’s the most common cause of bacterial meningitis in neonates?

A) Group A streptococcus
B) Neisseria meningitidis
C) Haemophilus influenzae
D) Group B streptococcus

D) Group B streptococcus

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A CSF sample from patient with acute meningitis showed many pus cells and gram negative diplococci. What is the most appropriate treatment?

A) Cafotaxime
B) Vancomycin
C) Clarithromycin

A) Cafotaxime

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For which of the following bacterial meningitis chemoprophylaxis for close contacts is recommended?

A) N. Meningitidis
B) S. Pneumoniae
C) M. Tuberculosis
D) L. Monocytogenes

A) N. Meningitidis

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A 26yrs old male had a RTA. Clinical and radiological examination showed no cerebral contusions, fractures, scalp injuries, and hematoma. He ended up dead a few days later. What post-mortem finding can be the cause of death?

A) Cerebral contusions
B) Subarachnoid hemorrhage
C) Diffuse axonal injury
D) Skull fracture
E) Laceration

C) Diffuse axonal injury

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A 32 year old man present with psychiatric symptoms and jerking movement in upper limb. His brother died 4 year ago and has same symptoms. What is the pathology under his condition?

Huntingtons

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An 80-year-old man with dementia died from myocardial infarction. Upon neuropathological examination, neurofibrillary tangles were found. What protein do these tangles compose of?

A) Amyloid
B) Prion
C) Tau
D) Alpha synuclein
E) Huntington

C. Tau

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Which of the following brain tumors is graded as WHO grade 1?

A) Pilocytic astrocytoma
B) Glioblastoma multiforme
C) oligodendroglioma
D) ependymoma
E) Diffuse astrocytoma

A) Pilocytic astrocytoma

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40 year women had a CT done for her head trauma. The CT scan showed a 3cm mass beneath the dura, compressing the underlying brain. Specimen showed elongated cells with pink cytoplasm forming whorls. What is the most likely diagnosis?

A) ependymoma
B) Astrocytoma
C) Oligodendroglioma
D) meningioma
E) Schwannoma

D) meningioma

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Which virus has a tendency to produce hemorrhagic necrosis in the inferior frontal and temporal lobes?

A) HSV
B) RABIES
C) MEASLES

A) HSV

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A 7 year-old boy died of delirium 4 weeks after school trip to explore caves, autopsy findings: perivascular lymphocytic infiltration, and intracytoplasmic inclusion. What is the cause?

A) Rabies
B) Measles
C) Poliovirus
D) Parvovirus

A) Rabies

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Demyelinating, long standing disease, brown in the white matter. Which stain?

luxol fast blue | Basically they’re asking which stain is good for myelin

A 52 year old man was febrile and had fever and vomiting. He was admitted to the hospital to correct hyponatremia. A few days later, the nurses realized he couldn’t move and was unresponsive, only showed signs of arousal and sleep. What is the diagnosis? A) severe demyelination in spinal cord B) symmetrical pontine demyelination

B) symmetrical pontine demyelination

A 24 year old healthy man who went camping in the mountains in the winter, is found dead in his tent by his friends. His tent had multiple empty bottles of beer and a coal burner. Upon postmortem examination, his skin showed a (bright?) velvety reddish discoloration, and a cut section of his brain showed multiple cherry red spots in the white matter. What is the likely cause of death in this person? ``` A) Acute alcohol intoxication B) Acute carbon monoxide poisoning C) High altitude mediated pulmonary edema D) Cardiac arrest due to hypothermia E) Fat embolisation syndrome ```

B) Acute carbon monoxide poisoning

which of the following occurs due to a mutation in PEX gene which result in perixisome protein abnormality? A) familial amyloid neuropathy B) zelweger syndrome

B) zelweger syndrome

Istradefylline used in the treatment of the off symptoms of Parkinson's disease. What is the mechanism by which it works?

Act on A2A adenosine receptors

Type of receptor btw preganglionic and postganglionic sympathetic? A) nicotinic receptor 2) muscarinic receptor 3) alph-adrenergic receptor 4) beta-adrenergic receptor

A) nicotinic receptor

What properties make a molecule effectively transported across the BBB? A) Low lipophilicity, MW < 4000, HB < 8 B) High lipophilicity, MW > 4000, HB > 8 C) High lipophilicity, MW < 4000, HB < 8 D) Low lipophilicity, MW > 4000, HB < 8

C) High lipophilicity, MW < 4000, HB < 8

Which drug inhibits DNA synthesis And is used to treat Cytomegalovirus- induced cephalitis? A) ganciclovir B) ampicillin C) acyclovir

A) ganciclovir

Which of the following drugs has the longest duration of action in the treatment of Alzheimer’s disease? A) Rivastigmine B) Galantamine C) Tacrine D) Donepezil

D) Donepezil

What is the main side effect for Tacrine? A) Ototoxicity B) Hepatotoxicity C) Nephrotoxicity D) Cardiovascular toxicity

B) Hepatotoxicity

which anti-epileptic drug induces hepatic enzymes causing many drug-drug interactions? A) vigabatrin B) tiagabine C) phenytoin D) gabapentin

C) phenytoin

what channel does lidocaine (local anesthetic) work on? A) Na+ B) K+ C) Cl- D) Ca2+

A) Na+

What is the mechanism of Midazolam?

GABA-A modulators → enhance GABA-mediated synaptic inhibition

Which anxiolytic-hypnotic drug causes endocrine changes like increasing prolactin and decrease testosterone levels? A) Ramelteon B) Zolpidem C) Zaleplon

A) Ramelteon

which of the following increases dopamine and noreadrenaline in the synaptic cleft? A) Nicotine B) Amphetamine C) cocaine

B) Amphetamine

What is the mechanism of action of fluoxetine? A) SSRI ( selectively inhibits serotonin reuptake) B) SNRI C) selective NE re-uptake inhibition D) MAOI

A) SSRI ( selectively inhibits serotonin reuptake )

What type of receptor does baclofen, a muscle relaxant, work on?

GABA-B receptor

Zolmitriptan act on which receptor?

5-HT1B/1D

Following a RTA, a 22-year-old male presents with loss of pain and temperature in his left lower limb and loss of proprioception and vibration in his right lower limb. Examination revealed spasticity in his right lower limb. Where would the lesion be located? A) right 12th thoracic vertebrae B) right 2nd lumbar vertebrae C) left 10th thoracic vertebrae D) left 4th lumbar vertebrae

A) right 12th thoracic vertebrae

A characteristic of cervical vertebra A) foramen transversarium B) large body C) prominent spinous process

A) foramen transversarium

Pedicle compress lateral spinal cord which sense is affected? ``` A) Pain B) Light touch C) Pressure D) Vibration E) Two-point discrimination ```

A) Pain

which of the following reflexes is absent in corticospinal tract injury? A) ankle reflex B) patellar reflex C) biceps tendon reflex D) superficial abdominal reflex

D) superficial abdominal reflex

Which one is responsible for extensor muscle tone? A) Tectospinal B) Vestibulospinal

B) Vestibulospinal

Which structure is not available in the medulla at the level of inferior olivary nucleus? A) medial leminuscus B) spinal leminicus C) inferior cellblar peduncle D) superior vestibular nucleus

D) superior vestibular nucleus

Posterior lower pons lesion, which is affected? ``` A) abducent nucleus B) CSF C) arcute fibers D) pontine nucleas E) trapzeiod body ```

A) abducent nucleus

An 8-year old girl with a diffuse astrocytoma of the pons in the cerebellopontine angle. Which nerve will be affected last? ``` A) Facial B) Glossopharyngeal C) hypoglossal D) trigeminal E) vestibulocochlear ```

D) trigeminal | confirmed by the dr

60 year old man had a stroke in ventral midbrain affecting the left crus cerebri, what will his symptoms be? A) Deviation of tongue to the right side B) Paralysis of right upper quadrant of face C) Paralysis of left lower quadrant of face D) Left shoulder drooping and brachial plexus neuralgia E) Loss of pain and temperature on the right

A) Deviation of tongue to the right side

A middle-aged female was diagnosed with an aneurysm of the posterior cerebral artery associated with pupillary dilatation. Which structure is the aneurysm is compressing in this patient? ``` A) Crus cerebri B) Optic nerve C) Oculomotor nerve D) Oculomotor nucleus E) Trochlear nerve ```

C) Oculomotor nerve

Vascular lesion in the paracentral lobule, what is a likely manifestation? A) difficulty moving the hand B) motor aphasia C) loss of micturition control D) Homonymous hemianopia

C) loss of micturition control | The idea is the paracentral lobule deals with the sensory and motor control of lower limbs and genitals

Old woman, Vascular lesion causing both eyeballs deviation towards the left. What is the site of the lesion?

Left frontal eye field (area 8 of the middle frontal gyrus)

What is the commissural fibers have role in light reflex ? A) Anterior commissure B) Posterior commissure C) Habenular commissure D) Corpus callosum

B) Posterior commissure

``` what would be the effect on motor and sensory if right anterior cerebral artery got damaged/occluded? A) right upper limb B) left upper limb C) lower right limb D) lower left limb E) both upper and lower limbs ```

D) lower left limb

Which of the following is a branch of vertebral artery that supplies part of the cerebrum? A) PICA B) Anterior middle cerebral artery C) AICA

A) PICA (PICA only supplies brain stem and cerebellum. Maybe the question was “supplies the Brain, but the tafreegh is incorrect, we’re not sure)

Which region of the cerebellum is related to distal limb movement? A) Superior vermis B) inferior vermis C) intermediate D) flocculonodular

C) intermediate

Which cerebellar afferent fiber form climbing fiber? A) olivocerebellar B) Spinocerebellar C) cuneocerebellar

A) olivocerebellar

How do climbing fibers cause LTP? A) phosphorylation of AMPA-R in purkinje cells B) phosphorylation of metabotropic glutamatergic receptors in purkinje cells C) closure of voltage gated calcium channels in purkinje cells D) something that happens in parallel fibers

C) closure of voltage gated calcium channels in purkinje cells

Radiography of the head shows one side lateral ventricle enlargement, but the other ventricles were normal. What affect CSF flow? A) Foramen of monro B) Foramen of magendie C) Cerebral aqueduct D) Foramen of luschka

A) Foramen of monro

A newborn has been diagnosed with a cleft in the iris , the defect in which gene responsible for that? A) noggin B) EMX C) PAX 2 D) SHH

C) PAX 2

Which of these afferent pathways releases serotonin? A) brainstem striatal fibers B) nigrostriate fibers C) thalamostriate fibers D) corticostriate fibers

A) brainstem striatal fibers

What best describes the substantia nigra pars compacta? A) Influence the direct pathway via D2 B) Influence the indirect pathway via D2 C) Release GABA at its terminal D) Release glutamate at its terminal

B) Influence the indirect pathway via D2

A 67 yr old man presented with chorioathetoid movements and loss of facial expression, if the thalamus was included, which thalamic nuclei is affected? A) Ventral posterior B) Ventral lateral C) Anterior

B) Ventral lateral

50 yrs old man came w headache. MRI showed aneurysm in ICA and cerebral arteries. What is an associted symptom? A) nasal hemianopia B) bitemporal hemianopia C) homonymous hemianopia

A) nasal hemianopia (ICA lies lateral to the optic chiasm, where the run on the side. So if an aneurysm compresses the side, the temporal optic fibers, which carry info from the NASAL hemifield, will be affected.)

What nucleus receives axons from the ganglion of retinal cells associated with spino-visual reflex ? A) Medial fasciculus B) Inferior olivary C) Superior colliculus D) Inferior Colliculus

C) Superior colliculus

A trainee doctor was asked to examine light reflex of a 70 year old patient. The right eye didnt constrict when the light was shone on it, however, the opposite eye constricted. What component of the reflex was the lesion located? A) right optic nerve B) left optic nerve C) right oculomotor nerve D) left oculomotor nerve

C) right oculomotor nerve

The floor of the middle ear lies above which structure? A) facial canal B) jugular fossa C) auditory tube D) carotid canal

B) jugular fossa

What is attatched to the center of the tympanic membrane? A) Chorda Tympani B) handle of malleus C) aditus to mastoid antrum

B) handle of malleus

If there’s damage to the Stapes*, what structure in the bony labryinth is affected? ``` A) Additus of the mastoid B) Vestibular window C) Cochlear window D) Cochlear duct E) Internal acoustic meatus ```

B) Vestibular window

The epithelial lining of Organ of Corti is supported by which structure? ``` A) Spiral limbus B) Tectorial membrane C) Basilar membrane D) Tympanic membrane E) Spiral ligament ```

C) Basilar membrane

What pathway connects the entorhinal cortex to the dentate gyrus? A) Mossy fibers pathway B) Perforant pathway C) Schaffer

B) Perforant pathway

Neurologist examined patient right big toe Moved it upward and downward but patient couldn’t tell the movement. Lesion of which thalamic nuclei caused this? A) Right VPL B) Left VPL C) right VPM D) left VPM

B) Left VPL

Lesion in which cranial nerve causes ptosis? A) Optic nerve B) Oculomotor C) Trochlear D) Trigeminal

B) Oculomotor

What is the neural response pattern when a pacianian corpusle is exposed to a constant stimuli? A) the response is high at the start and end of the stimuli B) the response progressively decreases towards the ends of the stimuli C) the response rapidly decreases towards the end of the stimuli D) the response is the same throughout the stimuli

A) the response is high at the start and end of the stimuli

What somatosensory works of piezo receptor?

touch

Which of the following contributes to synchronicity in brain oscillation? A) Synaptic transmission in excitatory or inhibitory brainstem neurons. B) Cortical neurons mutually and simultaneously excite or inhibit each other. C) Cortical and thalamic neurons change from burst to single spike activity. D) Acetylcholine and monoamine neurotransmitters at en passent synapses.

B) Cortical neurons mutually and simultaneously excite or inhibit each other.

What indicate the beginning of ictal phace A) disappearance of the after hyper-polarization B) appearance of the after hyper polarization C) parocymsmal depolarization shift

A) disappearance of the after hyper-polarization

Which of the following structures receives direct photic input ? A) dorsal medial hypothalamus B) lateral hypothalamus C) suprachiasmatic nucleus D) pineal gland

C) suprachiasmatic nucleus

Prolonged treatment with alpha 1 adrenergic antagonist what will happen to autoregulation? A. Lower limit of autoregulation of CBF is decreased B. Upper limit of autoregulation of CBF is decreased C. Upper limit of autoregulation of CBF is increased D. CBF changes linearly as long as cerebral perfusion pressure changes

Answer: We think both A&B are correct. Double check with the dr

Which substance is relesed from cortical neuron in respone to thalamic glutaminergic input Which causes vasodilatory effect on cerebral vascularsmooth muscle cells? A) nitric oxide B) Arachnoid acid C) potassium ion D) EET

A) nitric oxide

A 20 year old female presented with a weird gait with feet kept wide apart and irregular steps while walking(drawing). She was not under the influence of alcohol or any drug. Damage to which of the following areas causes these symptoms A) vestibular nuclei B) vestibulocerebellum C) spinocerebullum D) basal ganglia

C) spinocerebullum | If there was nausea/vomiting/nystagmus, the. It’s vestibulocerebellum

Which of following scenarios cause the largest increase in glutamate release from rods photoreceptors? A) subject closs eyes in dark room B) subject open eyes in dark room C) subject open eyes in well illuminated room D) subject closs eye in well illuminated room

C) subject open eyes in well illuminated room (The question is asking about the largest INCREASE. So in C, the rods will go from not releasing any glutamate when they are sensing the light in the room, to releasing a lot suddenly when we close our eyes.)

``` It was a long scenario, but the main idea was: what is the cause of increased action potential firing? A) opening of Na+ channel B) opening of K+ channels C) closing of Na+ channel D) clossing of K+ channels ```

B) opening of K+ channels

What will happen i if you rotate baby’s head to the right (without titling) A) flex the hand, extend the legs B) extend the hand, flex the legs C) right limbs extend, left limbs flexed D) right limbs flexed, left limbs flexed extend

C) right limbs extend, left limbs flexed

How many glumiuli in each olfactory bulb? A) less than 10 that correspond with spatial organization of olfactory bulb B) more than 10, that correspond with spatial organization nasal mucusa C) two, one for lateral on for medial olfactory stria D) same number as number of odorant receptor gene

D) same number as number of odorant receptor gene

Which best describes the sensory cortex columns processing A) Each column receives different areas from the skin B) Each column receives different sensory modalities C) Each column receives one sensory modality

C) Each column receives one sensory modality

What causes the disinhibition of the thalamocortical circuit?

Phasic inhibition of Gpi by the GABArgenic neurons of the striatum

What would be the most likely consequence of a lesion affecting area 3a of sensory cortex? A) impairment in the ability to recognize objects by touch B) deficiency in ability to differentiate between 2 adjacent skin touch stimuli C) inability to appraise the angle of limb joint when eyes are closed

C) inability to appraise the angle of limb joint when eyes are closed

Why a lipophilic molecule can enter cerebral Capillary endothelium but fails to cross blood brain barier? A) enzymatic degradation in CE B) degraded/taken up by astrocytes C) degraded/taken up by pericytes

A) enzymatic degradation in CE

A small water soluble molecule was injected to the interstitial fluid of the brain. Later it was detected in the CSF. How did this molecule gain access to the CSF? A) cross the BBB B) cross blood-CSF barrier C) pass between gaps of ependymal layer D) pass between gaps of choroidal capillary endothelial cells

C) pass between gaps of ependymal layer

How ghrelin acts on hypothalamus to regulate food intake? A) inhibit POMC/CART neurons B) stimulate neuronal activity in laterl hypothalamus C) stimulate NPY/AgRP neurons D) inhibit neurons in paraventricular nucleus

C) stimulate NPY/AgRP neurons

Which receptor is found at the synapse between pre & post ganglionic neurons of SNS?

Nicotinic Ach receptors

Temporal lobe seizures (know the symptoms from clinical med lecture!)

A case with the symptoms of parkinson “BRIT” + psychological symptoms + cogwheel rigidity

Parkinson’s disease

2018 module exam Flashcards

(96 cards)